Chemotherapy for resected colorectal cancer pulmonary metastases: Utilization and outcomes in routine clinical practice.

2017 ◽  
Vol 35 (8_suppl) ◽  
pp. 236-236
Author(s):  
Safiya Karim ◽  
Sulaiman Nanji ◽  
Kelly Brennan ◽  
C S. Pramesh ◽  
Christopher M. Booth
Keyword(s):  
Colorectal Cancer ◽  
Pulmonary Metastases ◽  
Controlled Trial ◽  
Routine Practice ◽  
Primary Colorectal Cancer ◽  
Factors Associated ◽  
Randomized Controlled ◽  
Ontario Cancer Registry ◽  
Study Population

236 Background: The role of chemotherapy in the setting of resected colorectal cancer pulmonary metastases (CRCPM) is not well defined. Here we describe utilization of peri-operative chemotherapy and outcomes among patients with resected CRCPM in the general population. Methods: All cases of CRCPM who underwent resection from 2002-2009 were identified using the Ontario Cancer Registry (OCR). Electronic treatment records identified peri-operative chemotherapy delivered within 16 weeks before or after pulmonary metastectomy (PM). Modified Poisson regression was used to evaluate factors associated with chemotherapy delivery. Cox proportional models were used to explore the association between post-operative chemotherapy and cancer-specific (CSS) and overall survival (OS). Results: The study population included 420 patients. Thirty-six percent of patients (151/420) received peri-operative chemotherapy. Among these patients, 75% (113/151) received post-operative chemotherapy. Factors that were independently associated with use of post-operative chemotherapy included higher socioeconomic status (SES) and no prior adjuvant chemotherapy (p < 0.01). In adjusted analyses post-operative chemotherapy was not associated with improved CSS (HR 0.99, 95% CI 0.67-1.47) or OS (HR 0.93 95%CI 0.66-1.31). In exploratory analyses, among those patients who did not receive previous adjuvant therapy for the primary colorectal cancer, post-operative chemotherapy following lung metastatectomy was associated with HR 0.50 (95%CI 0.27-0.95) for OS and HR 0.59 (95%CI 0.27-1.27) for CSS. Conclusions: One third of patients with resected CRCPM in routine practice receive peri-operative chemotherapy. A randomized controlled trial is warranted to evaluate whether chemotherapy following resection of CRCPM is associated with improved survival.

EXPRESS: Home-Tutoring Services Assisted with Technology: Investigating the Role of Artificial Intelligence Using a Randomized Field Experiment

2021 ◽  
pp. 002224372110503
Author(s):  
Jun Hyung Kim ◽  
Minki Kim ◽  
Do Won Kwak ◽  
Sol Lee
Keyword(s):  
Artificial Intelligence ◽  
Controlled Trial ◽  
Services Marketing ◽  
Learning Needs ◽  
Service Employees ◽  
Factors Associated ◽  
Randomized Controlled ◽  
Randomized Field Experiment ◽  
Service Outcomes

Despite a rising interest in artificial intelligence (AI) technology, research in services marketing has not evaluated its role in helping firms learn about customers’ needs and increasing the adaptability of service employees. Therefore, the authors develop a conceptual framework and investigate whether and to what extent providing AI assistance to service employees improves service outcomes. The randomized controlled trial in the context of tutoring services shows that helping service employees (tutors) adapt to students’ learning needs by providing AI-generated diagnoses significantly improves service outcomes measured by academic performance. However, the authors find that some tutors may not utilize AI assistance (i.e., AI aversion), and factors associated with unforeseen barriers to usage (i.e., technology overload) can moderate its impact on outcomes. Interestingly, tutors significantly contributing to the firm’s revenue relied heavily on AI assistance but unexpectedly benefited little from AI in improving service outcomes. Given the wide applicability of AI assistance in a variety of services marketing contexts, the authors suggest that firms should consider the potential difficulties employees face in using the technology rather than encourage them to use it as it is.

Role of preoperative pregabalin in reducing inhalational anesthetic requirements in abdominal hysterectomy: randomized controlled trial

2020 ◽  
Vol 86 (1) ◽  
Author(s):  
Nesrine A. El-Refai ◽  
Jehan H. Shehata ◽  
Ahmed Lotfy ◽  
Ahmed M. Elbadawy ◽  
Reham A. Abdel Rahman ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Abdominal Hysterectomy ◽  
Randomized Controlled ◽  
Inhalational Anesthetic

scholarly journals Robotic natural orifice specimen extraction surgery versus traditional robotic-assisted surgery (NOTR) for patients with colorectal cancer: a study protocol for a randomized controlled trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Rui Luo ◽  
Fangfang Zheng ◽  
Haobo Zhang ◽  
Weiquan Zhu ◽  
Penghui He ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Natural Orifice ◽  
Specimen Extraction ◽  
Natural Orifice Specimen Extraction ◽  
Robotic Assisted ◽  
Randomized Controlled ◽  
Robotic Assisted Surgery ◽  
Secondary Outcomes

Abstract Background Natural orifice specimen extraction surgery for colorectal cancer has been introduced in order to reduce the abdominal incision, demonstrating major development potential in minimally invasive surgery. We are conducting this randomized controlled trial to assess whether robotic NOSES is non-inferior to traditional robotic-assisted surgery for patients with colorectal cancer in terms of primary and secondary outcomes. Method/design Accordingly, a prospective, open-label, randomized controlled, parallel-group, multicenter, and non-inferiority trial will be conducted to discuss the safety and efficacy of robotic natural orifice extraction surgery compared to traditional robotic-assisted surgery. Here, 550 estimated participants will be enrolled to have 80% power to detect differences with a one-sided significance level of 0.025 in consideration of the non-inferiority margin of 10%. The primary outcome is the incidence of surgical complications, which will be classified using the Clavien-Dindo system. Discussion This trial is expected to reveal whether robotic NOSES is non-inferior to traditional robotic-assisted surgery, which is of great significance in regard to the development of robotic NOSES for patients with colorectal cancer in the minimally invasive era. Furthermore, robotic NOSES is expected to exhibit superiority to traditional robotic-assisted surgery in terms of both primary and secondary outcomes. Trial registration ClinicalTrials.govNCT04230772. Registered on January 15, 2020.

scholarly journals Role of Thermal Ablation in Colorectal Cancer Lung Metastases

Cancers ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 908
Author(s):  
Alexandre Delpla ◽  
Thierry de Baere ◽  
Eloi Varin ◽  
Frederic Deschamps ◽  
Charles Roux ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Prognostic Factors ◽  
Thermal Ablation ◽  
Medical Oncology ◽  
Pulmonary Metastases ◽  
Lung Metastases ◽  
Stereotactic Ablative Radiotherapy ◽  
Chest Drainage ◽  
Results Of Surgery

Background: Consensus guidelines of the European Society for Medical Oncology (ESMO) (2016) provided recommendations for the management of lung metastases. Thermal ablation appears as a tool in the management of these secondary pulmonary lesions, in the same manner as surgical resection or stereotactic ablative radiotherapy (SABR). Methods: Indications, technical considerations, oncological outcomes such as survival (OS) or local control (LC), prognostic factors and complications of thermal ablation in colorectal cancer lung metastases were reviewed and put into perspective with results of surgery and SABR. Results: LC rates varied from 62 to 91%, with size of the metastasis (<2 cm), proximity to the bronchi or vessels, and size of ablation margins (>5 mm) as predictive factors of LC. Median OS varied between 33 and 68 months. Pulmonary free disease interval <12 months, positive carcinoembryonic antigen, absence of neoadjuvant chemotherapy and uncontrolled extra-pulmonary metastases were poor prognostic factors for OS. While chest drainage for less than 48 h was required in 13 to 47% of treatments, major complications were rare. Conclusions: Thermal ablation of a selected subpopulation of patients with colorectal cancer lung metastases is safe and can provide excellent LC and delay systemic chemotherapy.

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